PHYSICAL EXAMINATION AND HEALTH ASSESMENT TESTBANK BY JARVIS:Chapter 13: Skin, Hair, and Nails

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1 The nurse educator is preparing an education module for the nursing staff on the epidermal layer of skin. Which of these statements would be included in the module? The epidermis is: a Highly... vascular. b Thick and tough. c Thin and nonstratified. d Replaced every 4 weeks. ANS: D The epidermis is thin yet tough, replaced every 4 weeks, avascular, and stratified into several zones. DIF: Cognitive Level: Understanding (Comprehension) REF: p. 199 MSC: Client Needs: General 2 The nurse educator is preparing an education module for the nursing staff on the dermis layer of skin. Which of these statements would be included in the module? The dermis: a Contains mostly fat cells. b Consists mostly of keratin. c Is replaced every 4 weeks. d Contains sensory receptors. ANS: D The dermis consists mostly of collagen, has resilient elastic tissue that allows the skin to stretch, and contains nerves, sensory receptors, blood vessels, and lymphatic vessels. It is not replaced every 4 weeks. DIF: Cognitive Level: Understanding (Comprehension) REF: p. 200 MSC: Client Needs: General 3 The nurse is examining a patient who tells the nurse, “I sure sweat a lot, especially on my face and feet but it doesn’t have an odor.” The nurse knows that this condition could be related to: a Eccrine glands. b Apocrine glands. c Disorder of the stratum corneum. d Disorder of the stratum germinativum. ANS: A The eccrine glands are coiled tubules that directly open onto the skin surface and produce a dilute saline solution called sweat. Apocrine glands are primarily located in the axillae, anogenital area, nipples, and naval area and mix with bacterial flora to produce the characteristic musky body odor. The patient’s statement is not related to disorders of the stratum corneum or the stratum germinativum. DIF: Cognitive Level: Applying (Application) REF: p. 200 MSC: Client Needs: Physiologic Integrity: Physiologic Adaptation 4 A newborn infant is in the clinic for a well-baby checkup. The nurse observes the infant for the possibility of fluid loss because of which of these factors? a Subcutaneous fat deposits are high in the newborn. b Sebaceous glands are overproductive in the newborn. c The newborn’s skin is more permeable than that of the adult. d The amount of vernix caseosa dramatically rises in the newborn. ANS: C The newborn’s skin is thin, smooth, and elastic and is relatively more permeable than that of the adult; consequently, the infant is at greater risk for fluid loss. The subcutaneous layer in the infant is inefficient, not thick, and the sebaceous glands are present but decrease in size and production. Vernix caseosa is not produced after birth. DIF: Cognitive Level: Applying (Application) REF: p. 201 MSC: Client Needs: Health Promotion and Maintenance 5 The nurse is bathing an 80-year-old man and notices that his skin is wrinkled, thin, lax, and dry. This finding would be related to which factor in the older adult? a Increased vascularity of the skin b Increased numbers of sweat and sebaceous glands c An increase in elastin and a decrease in subcutaneous fat d An increased loss of elastin and a decrease in subcutaneous fat ANS: D An accumulation of factors place the aging person at risk for skin disease and breakdown: the thinning of the skin, a decrease in vascularity and nutrients, the loss of protective cushioning of the subcutaneous layer, a lifetime of environmental trauma to skin, the social changes of aging, a increasingly sedentary lifestyle, and the chance of immobility. DIF: Cognitive Level: Applying (Application) REF: p. 201 MSC: Client Needs: Health Promotion and Maintenance 6 During the aging process, the hair can look gray or white and begin to feel thin and fine. The nurse knows that this occurs because of a decrease in the number of functioning: a Metrocytes. b Fungacytes. c Phagocytes. d Melanocytes. ANS: D In the aging hair matrix, the number of functioning melanocytes decreases; as a result, the hair looks gray or white and feels thin and fine. The other options are not correct. DIF: Cognitive Level: Understanding (Comprehension) REF: p. 201 MSC: Client Needs: Health Promotion and Maintenance 7 During an examination, the nurse finds that a patient has excessive dryness of the skin. The best term to describe this condition is: a Xerosis. b Pruritus. c Alopecia. d Seborrhea. ANS: A Xerosis is the term used to describe skin that is excessively dry. Pruritus refers to itching, alopecia refers to hair loss, and seborrhea refers to oily skin. DIF: Cognitive Level: Remembering (Knowledge) REF: p. 203 MSC: Client Needs: Health Promotion and Maintenance 8 A 22-year-old woman comes to the clinic because of severe sunburn and states, “I was out in the sun for just a couple of minutes.” The nurse begins a medication review with her, paying special attention to which medication class? a Nonsteroidal antiinflammatory drugs for pain b Tetracyclines for acne c Proton pump inhibitors for heartburn d Thyroid replacement hormone for hypothyroidism ANS: B Drugs that may increase sunlight sensitivity and give a burn response include sulfonamides, thiazide diuretics, oral hypoglycemic agents, and tetracycline. DIF: Cognitive Level: Applying (Application) REF: p. 204 MSC: Client Needs: Health Promotion and Maintenance 9 A woman is leaving on a trip to Hawaii and has come in for a checkup. During the examination the nurse learns that she has diabetes and takes oral hypoglycemic agents. The patient needs to be concerned about which possible effect of her medications? a Increased possibility of bruising b Skin sensitivity as a result of exposure to salt water c Lack of availability of glucose-monitoring supplies d Importance of sunscreen and avoiding direct sunlight ANS: D Drugs that may increase sunlight sensitivity and give a burn response include sulfonamides, thiazide diuretics, oral hypoglycemic agents, and tetracycline. DIF: Cognitive Level: Applying (Application) REF: p. 204 MSC: Client Needs: Physiologic Integrity: Reduction of Risk Potential 10 A 13-year-old girl is interested in obtaining information about the cause of her acne. The nurse should share with her that acne: 10.a Is contagious. 10.b Has no known cause. 10.c Is caused by increased sebum production. 10.d Has been found to be related to poor hygiene. ANS: C Approximately 90% of males and 80% of females will develop acne; causes are increased sebum production and epithelial cells that do not desquamate normally. DIF: Cognitive Level: Understanding (Comprehension) REF: p. 205 MSC: Client Needs: Health Promotion and Maintenance 11 A 75-year-old woman who has a history of diabetes and peripheral vascular disease has been trying to remove a corn on the bottom of her foot with a pair of scissors. The nurse will encourage her to stop trying to remove the corn with scissors because: The woman could be at increased risk for infection and lesions because of her chronic 11.a disease. With her diabetes, she has increased circulation to her foot, and it could cause severe 11.b bleeding. She is 75 years old and is unable to see; consequently, she places herself at greater risk for 11.c self-injury with the scissors. With her peripheral vascular disease, her range of motion is limited and she may not be able 11.d to reach the corn safely. skin holds information about a person’s: a Support systems. b Circulatory status. c Socioeconomic status. d Psychological wellness. ANS: B The skin holds information about the body’s circulation, nutritional status, and signs of systemic diseases, as well as topical data on the integumentary system itself. DIF: Cognitive Level: Understanding (Comprehension) REF: p. 210 MSC: Client Needs: Safe and Effective Care Environment: Management of Care 13 A patient comes in for a physical examination and complains of “freezing to death” while waiting for her examination. The nurse notes that her skin is pale and cool and attributes this finding to: 13.a Venous pooling. 13.b Peripheral vasodilation. 13.c Peripheral vasoconstriction. 13.d Decreased arterial perfusion. ANS: C [Show More]

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